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B/L ankle swelling
B/L ankle swelling 1 month. First one was swollen then the other. It is slightly pitting, warm to touch, tender and pain while walking. Left elbow and wrist stiffness. Knee pain (on and off). Serum urea creatinine and LFT normal. ESR elevated(72mm/hr). Her own sister is RF+. No fever.
X-ray is near normal . Needs clinical examination and blood tests - CRP , RA FACTOR / ANTI CCP , ANA . Start tab Etoricoxib 90 mg after breakfast and Pantocid 40 mg before breakfast .Daily walk for 45 min and exercises.
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There is good clinical suspicion of RHEUMATOID ARTHRITIS because high ESR AND MULTIPLE JOINT PAINS and stiffness
Next Steps
Need confirmatory tests like RA FACTOR IgM, Anti CCP ANTIBODIES. X ray knees and then review to see if MRI KNEE IS REQUIRED
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X ray shows age as 50 ? What's her blood pressure ? She need detailed clinical evaluation . Get some blood tests done FOR INFECTION / arthritic profile . For pain you may start with some painkiller but without consulting dr avoid self medication
Next Steps
blood investigation for arthritic profile , infection
Health Tips
video consult is one option
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Need to get inflammatory markers done - RA factor , uric acid , cbc
Next Steps
investigate
start treatment as per reports
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Sad to hear this
Want to rule out RA here
Get all the inflammatory parameters done
Next Steps
Get the following blood tests
RA Factor
CRP
Anti CCP
CBC
Health Tips
Get in touch with the reports
God bless !
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